Execution
- 1Position the patient prone with the foot over the table edge.
- 2Apply a blood pressure cuff around the mid-calf and inflates it to approximately 100 mmHg with the foot dorsiflexed.
- 3Ask the patient to actively plantarflex the ankle.
- 4Observe whether cuff pressure rises during plantarflexion effort.
- 5Compare with the opposite side if needed.
Positive outcome
Failure of cuff pressure to rise during attempted plantarflexion is positive for Achilles tendon rupture. In an intact tendon, pressure should rise, often toward approximately 140 mmHg. The test is less commonly used than Thompson and Matles.
Studies
| Study | Reliability | Sn | Sp | LR+ | LR− |
|---|---|---|---|---|---|
| Maffulli (1998) | prospective clinical study | 80 | NA | NA | NA |
CommentCopeland is a pressure-cuff version of active plantarflexion testing and was less sensitive than Thompson and Matles in Maffulli's study. It can be helpful when visual inspection is limited, but it is rarely the first-line clinical test. The Achilles rupture test group is high value collectively when multiple signs are positive.
Moderate Clinical Value